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Cited by 156Smoking Behavior and CessationCardiovascular Health and Risk FactorsAcute Myocardial Infarction Research

Importance of light smoking and inhalation habits on risk of myocardial infarction and all cause mortality. A 22 year follow up of 12 149 men and women in The Copenhagen City Heart Study

Open access
Prescott, E, Scharling, H, Osler, M, Schnohr, P·2002·Journal of Epidemiology and Community Health
DOI 10.1136/jech.56.9.702PMC PMC1732233
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Abstract

Study objective: To determine risk of myocardial infarction (MI) and all cause mortality associated with light smoking and inhalation habits in men and women. Design: Prospective cohort study with follow up of MI and all cause mortality through record linkage. Setting: The Copenhagen City Heart Study, a cardiovascular study based on a sample of the general population established in 1976. Participants: 6505 women and 5644 men followed up until 1998 for first MI and for death from all causes. Main results: During follow up 476 women and 872 men suffered a MI whereas 2305 women and 2883 men died. After adjusting for major cardiovascular risk factors there was a dose-response relation between smoking with and without inhaling and both MI and all cause mortality. Among inhaling smokers significantly increased risks were found in women at a consumption of only 3–5 grams of tobacco per day with relative risks (RR) of MI and all cause mortality of 2.14 (95% CI 1.11 to 4.13) and 1.86 (95% CI 1.37 to 2.51), respectively. In men increased risks were seen when smoking 6–9 grams per day with RR of MI and all cause mortality of 2.10 (95% CI 1.40 to 3.14) and 1.76 (95% CI 1.39 to 2.23), respectively. Risks were also increased in non-inhaling smokers, although in men only significantly so for all cause mortality. After adjusting for inhalation and quantity smoked, cigarette smokers had a higher risk of all cause mortality (RR 1.16 (95% CI 1.07 to 1.26)) but not of MI (RR 1.11 (95% CI 0.95 to 1.30)). The RR associated with smoking were significantly higher in women than in men for both MI and all cause mortality. Conclusions: Smoking as little as 3–5 grams of tobacco per day or not inhaling the smoke was shown to carry a significantly increased risk of developing MI and of all cause mortality with higher RR found in women than in men. The study emphasises the importance of recognising that even very limited tobacco consumption has detrimental health effects.

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  • The risk associated with smoking is primarily related to the amount of tobacco smoked daily and shows a clear dose-response relationship with no lower limit for deleterious effects.

    “The risk associated with smoking is primarily related to the amount of tobacco smoked daily and shows a clear dose-response relationship with no lower limit for deleterious effects.220”

    From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [220]

  • Abdominal aortic aneurysm is a coronary heart disease risk-equivalent condition.

    “Although abdominal aortic aneurysm is also a CHD risk-equivalent condition, there is no conclusive evidence that treatment with statins reduces perioperative CVD morbidity and mortality in these patients.220,487”

    From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [220]

  • There is no conclusive evidence that statin treatment reduces perioperative cardiovascular disease morbidity and mortality in patients with abdominal aortic aneurysm.

    “Although abdominal aortic aneurysm is also a CHD risk-equivalent condition, there is no conclusive evidence that treatment with statins reduces perioperative CVD morbidity and mortality in these patients.220,487”

    From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [220]

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Research works printed but not linked: 1

  1. Appleyard M, Hansen AT, Schnohr P, et al. The Copenhagen City Heart Study. A book of tables with data from the first examination (1976-78) and a 5-year follow-up (1981-83). Scand J Soc Med 1989;170:1-160.

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Authors
Prescott, E., Scharling, H., Osler, M., & Schnohr, P.
Affiliations
University of Copenhagen (DK)
Corresponding author
Prescott, E
ORCID
Prescott, E
Venue
Journal of Epidemiology and Community Health
Publisher
BMJ
Published
2002-09
Volume
56
Issue
9
Pages
702-706
ISSN
  • 0141-7681 (ISSN-L)
  • 0143-005X
  • 1470-2738
DOI
10.1136/jech.56.9.702
PMC
PMC1732233
OpenAlex
W2081944838
Cited by
154
References
23
Citations by year
2025: 1 · 2024: 3 · 2022: 3 · 2021: 7 · 2020: 10 · 2019: 7 · 2018: 6 · 2017: 8 · 2016: 12 · 2015: 3 · 2014: 8 · 2013: 5 · 2012: 18
FWCI
2.60
Type
journal article
Language
en
Open access
Locations
  • Journal of Epidemiology & Community Health (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
Funders
  • Hjerteforeningen
  • Ministeriet Sundhed Forebyggelse
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
Keywords
cigarette smoking, myocardial infarction, all-cause mortality, sex differences, dose-response relationship, tobacco use, cardiovascular risk, Copenhagen City Heart Study
MeSH terms
Adult, Aged, Cause of Death, Denmark, Female, Follow-Up Studies, Humans, Male, Medical Record Linkage, Middle Aged, Myocardial Infarction, Prospective Studies, Risk Factors, Sex Factors, Smoke, Smoking, Risk Assessment

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